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TCA 12 - Pneumonia > Pneumonia > Flashcards

Pneumonia Flashcards

1
Q

How can you diagnose pneumonia?

A

Signs of lower respiratory tract infections (fever/cough/phlegm/crepitations or bronchial breathing) + CXR changes

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2
Q

What is CAP?

A

Community acquired pneumonia

- Infection that has been acquired without any contact with healthcare services

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3
Q

What is HAP?

A

Hospital acquired pneumonia

- New onset of symptoms along with a compatible x-ray developing >48 hours after the patient’s admission to hospital

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4
Q

What are the sub-categories of HAP?

A

Early onset

  • Within 4-5 days of admission
  • More likely to be antibiotic-sensitive bacteria

Late onset

  • > 5 days of admission
  • More likely to be antibiotic resistant bacteria
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5
Q

What is VAP?

A

Ventilator associated pneumonia

- Occurs in patients on mechanical ventilation

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6
Q

What are the typical causes of CAP?

A 
o	Streptococcus Pneumoniae (most common)
o	Haemophilus influenzae
o	Moraxella catarrhalis 
o	Klebsiella pneumoniae
o	Staphylococcus aureus
o	Viruses

Mainly gram +ve cocci

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7
Q

What are the atypical causes of CAP?

A 
Legions of psittaci MCQs -> atypical pneumonia 
•	Legionella pneumophila
•	Chlamydophila Psittaci
•	Mycoplasma pneumoniae
•	Chlamydophila pneumoniae
•	Q-fever (Coxiella burnetiii)
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8
Q

What viruses commonly cause CAP?

A
  • Influenza A and B
  • Adenovirus
  • Para-influenzae
  • Respiratory synctal virus
  • SARS-CoV-2
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9
Q

What is distinctive about legionella species?

A
  • Caused by infected water supplies or air conditioning units (holiday)
  • Causes SIADH which causes Hypotranaemia
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10
Q

What is distinctive about mycoplasma pneumoniae?

A
  • Causes erythema multiforme

- Tends to effect younger patients

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11
Q

What is distinctive about chlamydia pneumoniae?

A
  • Occurs in outbreaks in families and institutions

- Extremities of age vulnerable

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12
Q

What is distinctive about coxiella burnetii?

A
  • Exposure to animals and bodily fluids
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13
Q

What is distinctive about chylamydia psittaci?

A
  • Infected birds

- Can occasionally cause hepatosplenomegaly

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14
Q

How do you treat atypical CAP organisms?

A

Macrolides
- Need to be treated with antibiotics which act in intracellular space as they do not have a cell wall (penicillin and cephalosporins act on the cell wall)

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15
Q

What are the common causes of late-onset HAP?

A

o Staphylococcus Aureus (including MRSA)
o Enterobacteria: E. coli, Klebsiella sp., Enterobacter sp., Serratia
o Pseudomonas sp.
o Environmental gram negatives: Acinetobacter ap., Stenotrophomonas, maltophilia

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16
Q

What is distinctive about staphylococcus aureus?

A
  • Grame +ve coccus
  • Upper respiratory tract commensal
  • Looks like bunch of grapes under microscope
17
Q

What is distinctive about enterobacteria?

A
  • Grame -ve bacilli
  • GI tract commensals
  • May be multi-drug resistant
18
Q

What is distinctive about the pseudomonas species?

A
  • Gram -ve bacillus

- Resistant to many antibiotics

19
Q

What is distinctive about environmental gram negatives?

A
  • Multi drug resistant and difficult to treat
20
Q

What causes aspiration pneumonia?

A

Inhalation of stomach contents or secretions of the oropharynx leading to lower respiratory tract infection

21
Q

Where is aspiration pneumonia most commonly seen and why?

A

Right lower lobe (RLL)

o Right main bronchus is straighter from the trachea compared to the left main bronchus.

22
Q

What is the most common fungal cause of pneumonia?

A

Pneumocystis jirovecii

23
Q

In which patients is fungal pneumonia most commonly seen?

A
  • Patients with altered cell-mediated immunity (immunodeficiency -> HIV, immunosuppression -> after transplantation)
  • Patients with a severe underlying respiratory condition (COPD, CF).
24
Q

What is distinctive about streptococcus pneumoniae?

A
  • Gram +ve coccus
  • Can be detected in blood culture or urinary antigen
  • Vaccine available
  • Causes rust coloured sputum
25
Q

What is distinctive about haemophilus influenzae?

A
  • Gram -ve bacillus
26
Q

What is distinctive about moraxella catarrhalis?

A
  • Associated with immunocompromised patients and those with chronic lung disease
27
Q

What is distinctive about klebsiella pneumoniae?

A
  • Commensal organism of the GI tract

- Tends to affect upper lobes

28
Q

What is distinctive about staphylococcus aureus?

A
  • Gram +ve coccus
  • IVDU at risk
  • Chronic lung pathology a risk factor

TCA 12 - Pneumonia (5 decks)

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